Presented by Fred Unger at the 3rd International Conference on One Health 2020, Veterinary Science Innovation for Ecosystem Health and Resilience, Malang, Indonesia, 30 October 2020.

1. Better lives through livestock
Traditional food chains–some thoughts on terminologies, perceptions and
how-to-de-risk them to cope with food safety and pandemic threats
Fred Unger1, Hung Nguyen1, Pham Duc Phuc2, Pham Van Hung3, Huyen Le Thi Thanh4, Xuan Dang Sinh1, Sothyra Tum5, Rortana Chea5, Chhay Ty6,
Nguyen Thanh Luong2, Hai Ngo Hoang Tuan2, Delia Grace1
1International Livestock Research Institute, Vietnam and Kenya; 2Hanoi University of Public Health, Vietnam; 3Vietnam National University of Agriculture, Vietnam;
4National Institute for Animal Science, Vietnam; 5National Animal Health and Production Research Institute, Cambodia; 6Centre for Livestock and Agriculture, Development, Cambodia
30 October 2020, Faculty of Veterinary Medicine Universitas Brawijaya, Malang, Indonesia
3rd International Conference on One Health 2020
Veterinary Science Innovation for Ecosystem Health and Resilience

2. Main campuses: Nairobi, Kenya and
Addis Ababa, Ethiopia
Hanoi office (East and SE Asia region):
- Food safety, one health & ASF
International Livestock Research Institute (ILRI)
- Part of CGIAR system with 15 research centres worldwide
Reduce
poverty
Improve
food and
nutrition
security
Improve
natural
resources
and
ecosystem
services
CGIAR COVID-19 Hub
launched in Jun 2020

3. 3
Menti-Question
Go to menti.com, and enter code 5887369
Where do you usually buy animal source food (e.g. chicken)
(click only one but most valid option)
-Traditional retail
-Supermarket or convenient stores
-Organic/healthy food stores
-Directly at producer
-Other

4. 4
Contents
• Livestock, SDG, food system change &
consequences
• Food safety - global
• Traditional food chains
• Food safety performance - Vietnam
• Intervention example
• Way forward and future research

5. Agenda 2030’s Sustainable Development Goals
Livestock contribute to all 17 of the SDGs and directly to at least 8 of
the goals.

6. 6
Population grow & urbanization
• World population was estimated at 6.8 billion in 2009, with
5.6 billion living in the less developed regions (UN, 2009)
• Current estimates are that the population will grow to 9.1
billion in 2050, with most of the growth occurring in
developing countries (UN, 2009)
• Population living in urban areas is projected to rise from 3.3
billion in 2007 to 6.4 billion 2050 (World Urbanization
Prospect)

7. 0
50
100
150
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250
E.Asia
Pacific
China
South
Asia
SSA
High
income
7
0
50
100
150
200
250
E.Asia
Pacific
China
South
Asia
SSA
High
income
0
50
100
150
200
250
300
350
400
E.Asia
Pacific
China
South
Asia
SSA
High
income
0
50
100
150
200
250
E.Asia
Pacific
China
South
Asia
SSA
High
income
Estimates of the % growth in demand for animal source foods in different World regions, comparing 2005 and 2030.
Estimates were developed using the IMPACT model, courtesy Dolapo Enahoro, ILRI.
Beef Pork
Poultry Milk
Increases not because of
overconsumption!
% growth in demand for livestock products to 2030 (versus 2005)

8. Proportion of livestock-derived foods produced by small farms in 2010
Source: Options for the Livestock Sector
in Developing and Emerging Economies
to 2030 and Beyond. World Economic
Forum White Paper January 2019

9. 9
Food system change & consequences
• Food systems are rapidly changing in many
developing countries, e.g. including Vietnam, 4-5 %
grow of livestock sector
• These transitions are likely to be associated with more
consumption of risky food
• Milk, meat, aquatic products and crops
• Food safety is an emerging public health problem
worldwide

10. Food safety – global perspective
WHO’s report: Global estimates of foodborne diseases
• For the global estimates, 31 foodborne hazards causing 32 diseases were
included, being diarrheal disease agents, invasive infectious disease
agents, helminths and chemicals
• Estimated global burden these 31 hazards was 33 million DALYs
– Comparable with burden from Malaria, HIV and TB
• Almost 1 in 10 people fall ill every year from eating contaminated food
• Children under 5 years of age from low income countries are at
particularly high risk
• Highest burden observed for Africa (East and Central SH Region)
followed by South East Asian (region II)
http://www.who.int/foodsafety/publications/
foodborne_disease/fergreport/en/

11. Food safety – global perspective
WHO’s report: Global estimates of foodborne diseases
• Diarrhoeal diseases responsible for more than half of the global
burden of foodborne diseases, with 230 000 deaths every year.
• Major causes of diarrhoea: norovirus, Campylobacter, non-
typhoidal Salmonella and pathogenic E. coli.
• Causes and impact of FBD vary widely e.g. by region: Taenia
solium, O. V., and aflatoxins.
http://www.who.int/foodsafety/publications/
foodborne_disease/fergreport/en/

12. Traditional food chains – (traditional)/wet markets
Terminology
• It refers to traditional markets which sell mainly fresh
foods such as meat, some seafood, fruits and vegetables.
• Usually less regulated
• Consist of different stalls with independent owners
• Frequent use ice to keep food fresh and often wash
products to keep them clean and fresh.
“wet market”
Photo credit: Chea Rortana /ILRI 2020

13. Formal versus informal retail
• Formal retail: supermarkets, convenient stores,
“healthy” food shops
• Informal retails include:
 traditional markets and or ‘wet markets’
 Street and /or street food vendors
• Traditional, wet or ‘informal’ markets supply >80%
of the food consumed in sub-Saharan Africa*, but
also the region e.g. Vietnam and Cambodia
• Often escape structured sanitary inspection and lack
modern infrastructure and modern management
*Predicted to still meet 50 to 70 % of consumer demand for food by 2040
Photo credit: Chea
Rortana, Chi Nguyen
/ILRI 2020

14. Why customers prefer traditional/wet markets
• Accessibility, numerous in urban areas but often the
only source in rural areas
• Cheaper than formal/modern retail (opposite to
developing countries – “organic” markets – pricy)
• Addressing specific consumer demands
 Sell of traditional foods (including wildlife)
 Certain meat pie, blood pudding
• Livelihood contribution
 Income for retailers (many are women) & smallholder
• Consumers associate wet markets with fresh, local,
“healthy by nature foods”
• Tourist attractions
Photo credit: Unger,
Chi Nguyen /ILRI

15. Traditional/wet markets are not the same
• Many markets sell fresh meat (often from animals killed
that morning)
• Live birds and live aquatic food, often killed on spot or
taken home alive
• Only a minority of markets sell wildlife: may be alive or
freshly killed
• Markets vary from permanent structures with
electricity, running water and concrete walls and floors
to wooden structures with semi thatch covering, to food
sold on the ground in the open air
• Operation time varies: daily, some days week or less
Photo credit: Chea Rortana, Chi Nguyen /ILRI

16. Risk at traditional/wet markets
The risk to human health is little understood and variable.
There are both risk amplifying and mitigating practices and
characteristics in wet markets. Some of these are shown below:
Risk mitigating and risk amplifying characteristics of wet market
Risk mitigating Risk amplifying
Separation between types of fresh food
(fresh/cooked or intestines and meat)
Direct or indirect contact with body fluids or
between intestines and meat
Basic infrastructure: water, electricity, easy to
clean surface
Keeping and slaughter live animals
Rapid turnover, selling in small amount Selling on the ground/floor
Trust in vendor Lack of effective, risk based inspection
Short value chain Poor infrastructure: lack of water and electricity

17. Will modern retail replace traditional/wet markets?
Modern retail:
Based on experiences on rapid growth of modern retail from other parts of the world (America, Europe,
Australia, South America) the same was assumed for Africa and Asia.
But there are crucial differences.
• Modern retail in Asia and Africa does not offer offered fresh food at lower cost than traditional retail
• There is also a strong preference for “warm fresh meat” = not chilled or frozen food in Africa and Asia.
• Selection process of meat may include even check of consistence /“touching” of meat
• Perception that modern retail uses more “chemicals” e.g. grow promoters & consequently different
perceived meat taste and quality
“premium shops”
Shops specialising in selling “health” fresh food at a premium (rather small outlets)
Co-existence of traditional and modern retail
For richer customers, wet markets and modern retail may be complementary rather than competitive
• people buying packaged food in supermarkets and fresh food in wet markets
Photo credit: Chi
Nguyen/ BacTom ILRI

18. Shall we worry about wet markets?
Food safety
Wet markets often lack adequate infrastructure and food safety measures:
 Hazards can be high, but risks can be low if post processing involves a
reliable control step
 The informal sector is not always dangerous and the formal sector is not
always safe.
 The formal sector is more vulnerable to system failures
Transmission of emerging diseases
• HPAI pandemic - many efforts to regulate or stop e.g. sale of live
birds but not always effective
• Coronavirus emergence has also been associated with sale of wild
animals in wet markets but majority wild animals are not sold in wet
markets.
• Role of wet markets in the recent pandemic not fully understood

19. How to reduce risk from wet markets
Attempt and challenges:
• Improve infrastructure
 But without changing retailers behaviour and practice tends to be
unsustainable
• Training retailers helps to improve food safety
 But without incentives, improvements are not sustained
• Ban wet markets have usually failed and often had serious un-intended
consequences.
• Enforcing high standards such as modern retail often failed to
• So far there was limited investment and research into informal markets

20. What can be done differently?
Existing regulations sometimes inappropriate or not exist e.g. for small-scale
slaughter
Rather gradual upgrading of existing structure than infrastructure change
• Provide simple technologies to make food safe (e.g. cheap, easy to clean
surfaces)
Participatory, risk-based, demand-led approaches seem most promising (not-
top down or purely regulatory)
Understanding health risk from informal markets (as opposed to presence of
hazards)
Tackling most risky features first
Implementing and evaluating potentially scalable and sustainable interventions

21. ILRI’s current research on pork value chains in Vietnam & Cambodia
• Pork is most important meat diet for consumers (similar in Laos,
Thailand and Cambodia)
• Most of this is produced, slaughter and sold in traditional
markets
• Food safety has become an increasing concern (consumers &
policymakers)
• Concerns include contamination with chemical and
microbiological hazards
• Little information on the actual risks or how to manage them.

22. Food safety performance tool Aim & pillars: Safety, scalability and societal concerns
Safety: Core of the tool using a risk-based approach to provide robust
assessments of food safety outcomes food commodity (e.g. pork).
Sustainability and scalability assessment of the value chain.
• Business performance (e.g. market share, expected trends, potential for change)
and supply chain governance (e.g. trust and interventions).
Societal concerns
• supplementary to pillar 1 and 2 such as gender and equity, cultural norms
etc. which may synergize or trade-off with food safety.
A value chain may provide safe food but have little potential for scaling (e.g. niche products)
Aim: Allow rapid assessment of food safety outcomes in value chains

23. How the tool was used
• Qualitative (focus group discussions, FGD, key informant interviews, KII)
• > 500 KII and 12 FGD
• Content: Business scale & trends, trust, governance, KAP, intervention (perception)
• Farm to fork
• Quantitative (biological sampling and observational checklist) using a
probabilistic sampling design to ensure representativeness.
• >700 samples collected across different pork value chains
• Value chains (Sep 2018 – May 2019):
Traditional/
wet market
(all sites)
Street food,
Hanoi
Canteens, Hanoi„Boutique“ food
chains, niche but
emerging, Hanoi
Supermarket/
convienient
stores, Hanoi
Native pigs,
Hoa Binh, „safe
by nature“
*Photo credit: Chi N/ILRI and BacTom 2018

24. 24
Key results
Safety:
 Poor food safety outcomes across all retail types
 Value chain actors incorrectly perceive chemical hazards as more
important than microbiological
 Poor hygiene was blamed as the main reason leading to
foodborne disease, but this perception wasn’t necessarily
translated into better practice

25. 25
Key results
Scalability/sustainability:
 Business of pork value chain slowly recovers from ASF, rather minor
affect of COVID-19
 Overall trust levels on food safety decrease from rural to urban areas
 Trust was lowest with social media and highest with TV and local radio
 Traditional markets and slaughter will continue to provide most pork
and should continue to be a focus

26. 26
Key results
Societal norms:
 Women seem more cautious about chemical residues in pork/food than
men.
 Women also worry more about foodborne disease more frequently than
men.
 Man more in favour of purely technical interventions than woman
Chosen value chains for intervention based on results from FS performance:
 Small-scale traditional sector (slaughter and retail)

27. Handbooks
INTERVENTION
Development of Instruction & Training materials
Food safety intervention at slaughter* and retail
Approach:
• Participatory risk-assessment
• Supportive formative research with model
retailers
• Risk communication
Key content*:
-Grid slaughter
-Frequent washing
(and disinfection)
-Training
-Separation
clean/dirty
-Branding
Key content:
-Easy to clean surface
-Frequent washing (and
disinfection)
-Separation (fresh/cooked)
-Training
-Hygienic cutting board
-Branding
*only Vietnam

28. INTERVENTION
Results at SH
Grid
Hand disinfection liquid
Faucet
Installed grid
Re-organized water and
electrical system
Training for SH owners &
workers
Food safety intervention at slaughter - example
Photo credit: Sinh Dang Xuan/Chi Nguyen ILRI 2020

29. INTERVENTION
Development of Instructions & Training materials
Change of workflow (clean/dirty) Posters to support
behavior change
Avoid floor slaughter
• Marked decrease of coliforms; investment 100 -1500 USD
• COVID-19 concerns help to convince butchers and retailers to use disinfectant
Food safety intervention at slaughter - example
Photo credit: Sinh Dang Xuan/Chi Nguyen ILRI 2020

30. Food safety pilot intervention at retail – Vietnam
Package: Easy to clean table surface, inox tray, separation of raw/cooked pork,
cutting board, and detergent/disinfection & training: less than 25USD
Tendency of hygienic improvement (surfaces) Photo credit: Sinh Dang Xuan ILRI 2020

31. 31
Food safety pilot intervention at retail - Cambodia
Tendency of hygienic improvement (pork)
Package: Easy to clean table surface, separate meat from intestine, inox tray,
cuttings board, cloths and detergent/disinfection & training: less than 20USD
Photo credit: Rortana Chea ILRI 2020
Since COVID 19 emergence we see some better compliance on the use of disinfectant

32. Preliminary results from COVID-19 impact survey at
traditional retail in Vietnam
Hygiene behaviour & practices changes – before/during/after lock down
• Cleaning/sanitizing working facilities/tools - more frequent, especially in urban
context
• Most observed changes: in washing & sanitizing hands AND wearing masks &
gloves during working (selling), especially in urban
– remained after lockdown although less popular in rural
• Keeping meat chilled or frozen becoming (somewhat) more frequent,
especially in urban
• During lockdown: less eating at meat stalls BUT after lockdown resuming in urban
while remaining in rural (perhaps because of the longer selling/working time in
urban?)
Methodology: 150 traditional retailers (75 urban and 75 rural), KII on impact
and hygienic practice change, also done in Thailand, Laos and Cambodia

33. 33
Take home messages
 Population grow and aligned higher demand for livestock may lead
to increase risks
 Traditional retail plays an important role in Asia and Africa and will
remain to do so
 The informal sector is not always dangerous and the formal sector is
not always safe
 Western based mitigation approaches to cope with risks from
informal sector may not be effective
 Results from pilot interventions at traditional slaughter and retail are
promising but further consolidation required
 COVID-19 pandemic tends to result in better compliance of retailers

34. 34
Future research around traditional retail my include:
• Understanding typologies, harms and benefits of formal and
informal markets across criteria such as: health, nutrition,
livelihoods, accessibility
• Understanding health risk from those markets (opposed to presence
of hazards)
• Participatory risk-assessment
• Identification of risk mitigating, scalability and practices at these
• Consider also societal aspects
• Identify low-cost solutions combined with training and incentives
• Explore COVID-19 as an opportunity for better compliance of food
retailers

35. Further readings:
Video: https://www.youtube.com/watch?v=-CZVyxCG8Zk
Research briefs: https://cgspace.cgiar.org/handle/10568/108320; https://hdl.handle.net/10568/108768; https://hdl.handle.net/10568/108769;
https://hdl.handle.net/10568/102172
Reports: https://www.worldbank.org/en/country/vietnam/publication/food-safety-risk-management-in-vietnam-challenges-and-opportunities
CGIAR COVID-19 Hub: http://a4nh.cgiar.org/covidhub/
Vietnam 57th day without
community COVID-19 cases!
11-25 Sep quarantine
Disinfection liquid
Photo credit: Unger/Rortana Chea/Sinh Dang Xuan/Chi Nguyen/Unger ILRI 2020

36. Acknowledgement
Further acknowledgement:
Florence Mutua, Kristina Roesel, Lian Thomas, Silvia Alonso, and Theo Knight-Jones (all ILRI)
Siobhan Mor (Institute of Infection and Global Health at the University of Liverpool and ILRI)